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Longitudinal evaluation of growth in oesophageal atresia patients up to 12 years
  1. Floor W T Vergouwe1,2,
  2. Marjolein Spoel1,
  3. Nicole W G van Beelen1,
  4. Saskia J Gischler1,
  5. René M H Wijnen1,
  6. Joost van Rosmalen3,
  7. Hanneke IJsselstijn1
  1. 1Department of Intensive Care and Pediatric Surgery, Erasmus MC University Medical Center—Sophia Children's Hospital, Rotterdam, The Netherlands
  2. 2Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
  3. 3Department of Biostatistics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
  1. Correspondence to Dr Marjolein Spoel, Department of Intensive Care and Pediatric Surgery, Room Sk 1280, Erasmus MC University Medical Center—Sophia Children's Hospital, P.O. Box 2040, Rotterdam 3000 CA, The Netherlands; m.spoel{at}erasmusmc.nl

Abstract

Objective Previous studies reported diminished growth after oesophageal atresia (OA) repair. We evaluated long-term follow-up data on growth.

Methods Longitudinal cohort study up to 12 years. Patients with OA, born 1999–2013, who participated in a longitudinal follow-up programme were included. Children with genetic syndromes associated with growth disorders were excluded. SD scores (SDS) for height-for-age (HFA), weight-for-height (WFH) and distance-to-target-height were calculated for routine visits (0.5/1/2/5/8/12 years). Linear mixed models were used to estimate SDS until 12 years of age and to evaluate explanatory factors for growth.

Results We included 126/155 children (32% prematurely born, 20% small for gestational age), 32 reached the age of 12 years. Fundoplication surgery was performed in 24%. SDS-HFA was below normal up to 8 years but improved over these years (mean (SE) −0.48 (0.09), −0.31 (0.09) and −0.20 (0.13) at 0.5, 8 and 12 years). Scores improved after correction for target height (mean (SE) −0.29 (0.10), −0.17 (0.09) and −0.10 (0.14) at 0.5, 8 and 12 years). SDS-WFH was below normal from age 1–5 years (mean (SE) −0.53 (0.09), −0.24 (0.09) and 0.03 (0.14) at 1, 5 and 12 years). Low birth weight and fundoplication surgery were negatively associated with growth.

Conclusions The growth of patients with OA was below the reference norm during the first years of life, but normalised at 12 years. Large longitudinal cohort studies should evaluate if normal growth persists into adolescence. Early nutritional assessment with timely dietary intervention should be considered especially in those with low birth weight or following fundoplication surgery.

  • Growth
  • Malnutrition
  • Oesophageal atresia
  • Outcome
  • Risk factors

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Footnotes

  • Competing interests None declared.

  • Ethics approval Medical Ethics Committee of Erasmus MC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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